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Pharm Unit 3 Drugs > MS Drugs > Flashcards

MS Drugs Flashcards

1
Q

IFN-beta-1a (Avonex)Misc

A

Doesn’t cross BBB; decreases relapse rate by 1/3 and reduces MRI lesions, with a trend toward decreasing disability and brain atrophy

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2
Q

IFN-beta-1a (Avonex) Class

A

IFN-beta-1a

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3
Q

IFN-beta-1a (Rebif) Class

A

IFN-beta

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4
Q

Glatiramer acetate (Copaxone) Class

A

Myelin basic protein analog

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5
Q

Natalizumab (Tysabri) Class

A

Monoclonal antibody

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6
Q

Fingolimod (Gilenya) Class

A

Sphingosine-1-phosphate analog

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7
Q

Mitoxantrone (Novantrone) Class

A

Anthracenedione

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8
Q

Azathioprine (Imuran) Class

A

Immunosuppressants

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9
Q

Methotrexate (Trexall) Class

A

Immunosuppressants

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10
Q

Cyclophosphamide (Cytoxan) Class

A

Immunosuppressants

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11
Q

Mycophenolate mofetil (CellCept) Class

A

Immunosuppressants

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12
Q

Methylprednisone (MTP) Class

A

Corticosteroid (immunosuppressant)

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13
Q

IFN-beta-1a (Avonex) MOA

A

Many, potentially: inhibit T-cell activation, shift from Th1 to Th2, inhibit lymphocyte movement into CNS, anti-proliferative effect, apoptosis of T-cells, anti-viral, IFN-g antagonism

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14
Q

IFN-beta-1a (Rebif) MOA

A

Many, potentially: inhibit T-cell activation, shift from Th1 to Th2, inhibit lymphocyte movement into CNS, anti-proliferative effect, apoptosis of T-cells, anti-viral, IFN-g antagonism

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15
Q

Glatiramer acetate (Copaxone) MOA

A

Mixture of 4 AAs in myelin basic protein; causes T-cell apoptosis (looks like MBP), induces anti-inflammatory Th2 cells (cytokine shift from Th1), induces Treg with induction of anergy

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16
Q

Natalizumab (Tysabri) MOA

A

Binds VLA4 (integrin subunit), inhibiting leukocyte migration across BBB

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17
Q

Fingolimod (Gilenya) MOA

A

Prodrug; sequesters circulating lymphocytes in secondary lymphoid organs via induction of intracellular internalization of receptors on lymphocytes (no effect on lymphocyte induction, proliferation, or memory function)

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18
Q

Dimethyl fumarate (Tecfidera) MOA

A

Enhances Nrf2 pathway; some Th1 -> Th2 sgift

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19
Q

Mitoxantrone (Novantrone) MOA

A

Broad immune suppression and modulation of B cells, T cells and macrophages; decreases frequency of clinical relapse, reduces disease progress, and reduces disability

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20
Q

Azathioprine (Imuran) MOA

A

Immunosuppressive

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21
Q

Methotrexate (Trexall) MOA

A

Immunosuppressive

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22
Q

Cyclophosphamide (Cytoxan) MOA

A

Immunosuppressive

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23
Q

Mycophenolate mofetil (CellCept) MOA

A

Immunosuppressive

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24
Q

Methylprednisone (MTP) MOA

A

Unclear mechanism (suppress both B and T cells, may reduce cytokine release)

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25
Plasmapharesis MOA
Unclear mechanism
26
IFN-beta-1a (Avonex) Therapeutics
RRMS
27
IFN-beta-1a (Rebif) Therapeutics
RRMS (high-dose); first-line treatment (more efficacious than Avonex in head-to-head trials)
28
Glatiramer acetate (Copaxone )Therapeutics
RRMS
29
Natalizumab (Tysabri) Therapeutics
RRMS (2nd line)
30
Fingolimod (Gilenya) Therapeutics
RRMS
31
Dimethyl fumarate (Tecfidera) Therapeutics
---
32
Mitoxantrone (Novantrone) Therapeutics
SPMS; RRMS (2nd line)
33
Azathioprine (Imuran) Therapeutics
SPMS (resistant, or as combination with other therapies)
34
Methotrexate (Trexall) Therapeutics
SPMS (resistant, or as combination with other therapies)
35
Cyclophosphamide (Cytoxan) Therapeutics
SPMS (resistant, or as combination with other therapies)
36
Mycophenolate mofetil (CellCept) Therapeutics
SPMS (resistant, or as combination with other therapies)
37
Methylprednisone (MTP) Therapeutics
Acute MS attack, SPMS; shortens acute attack duration,speeds recovery
38
ACTH Therapeutics
Acute MS attack (if patient allergic to corticosteroids, poor IV access); or if MTP doesn't work
39
Plasmapharesis Therapeutics
Acute MS attack not responsive to MTP
40
IFN-beta-1a (Avonex) SE
1. Mild anemia, increase LFT (monitor every 6 mo.), hypothyroid; least NAB formed 2. Flu-like, minor irritation at inject site, anemia
41
IFN-beta-1a (Rebif) SE
1. Anemia, leukopenia, menstrual irregularities, depression, increase LFT and hypothyroidism (monitor every 3 mo.) 2. Flu-like, injection site reaction; neutropenia; thrombocytopenia
42
Glatiramer acetate (Copaxone ) SE
Mild: injection site reaction, anxiety attack-like reaction
43
Natalizumab (Tysabri) SE
1. PML (JC virus); acute urticaria, systemic hypersensitivity infusion reaction 2. Headache, dizziness, fatigue, arthralgia, rigors
44
Fingolimod (Gilenya) SE
1. Bradycardia and heartblock (EKG for first 6 hours); macular edema (need opthalmology exam before and after 3 months) 2. Reduced FEV1, increased LFTs, lymphopenia, leukopenia, asthenia, back pain, blurred vision, headache dizziness, infections
45
Dimethyl fumarate (Tecfidera) SE
1. N & V; diarrhea; stomach pain; flushing 2. Itching, redness, rash
46
Mitoxantrone (Novantrone) SE
1. Dose-dependent cardiac toxicity (decreased LVEF, irreversible CHF); induction of acute leukemia 2. Nausea and vomiting, alopecia, menstrual irregularities, increased susceptibility to infection
47
Azathioprine (Imuran) SE
Systemic toxicity: monitor blood for changes
48
Methotrexate (Trexall) SE
Systemic toxicity: monitor blood for changes
49
Cyclophosphamide (Cytoxan) SE
Systemic toxicity: monitor blood for changes
50
Mycophenolate mofetil (CellCept)SE
Systemic toxicity: monitor blood for changes
51
Methylprednisone (MTP) SE
Short-term: insomnia, mood changes, fluid retention, epigastric pain, hypertension; long-term: osteoporosis, cushingoid, secondary malignancies
52
IFN-beta-1a (Avonex)Misc
Doesn't cross BBB; decreases relapse rate by 1/3 and reduces MRI lesions, with a trend toward decreasing disability and brain atrophy
53
IFN-beta-1a (Rebif) Misc
As with Avonex; significantly reduces new and enhancing MRI lesions, reduces disablity
54
Glatiramer acetate (Copaxone ) Misc
Active in CNS (not peripherally); try to use early; reduce relapse by 1/3, modest reduction in MRI lesion and reduction of atrophy, but no effect on disease progression
55
Natalizumab (Tysabri) Misc
Decrease relapse rate by 2/3, greatly reduce MRI lesions; once/month; antibodies to natalizumab cause it to stop working; side effects more common in patients positive for neutralizing antibodies
56
Fingolimod (Gilenya) Misc
Patients must be VZV immune before prescription; oral daily
57
Dimethyl fumarate (Tecfidera) Misc
Oral BID
58
Mitoxantrone (Novantrone) Misc
IV; once/3 months
59
Mycophenolate mofetil (CellCept) Misc
Oral
60
Methylprednisone (MTP) Misc
Given IV with oral prednisone taper

Pharm Unit 3 Drugs (13 decks)

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